That We May Be

When I was seven I knew I wanted to be a doctor. When I was 17, I knew I couldn't. Now that I am 41, I agree with the White Queen—I have believed as many as six impossible things before breakfast. At the time, I did not understand that earning a D in science at Exeter didn't matter. But learning how to learn, to seek out and examine data, to ruthlessly evaluate and honestly discard, these skills I took with me when I left. And I took them with me recently when I attended a conference on the nature of cancer.

For classmates who knew me at Exeter as an apprentice Jehovah's Witness, I will note that 16 years ago I married an evolutionary biologist (a paleobotanist), which just goes to prove that God has an excellent sense of humor. Bruce attended this conference in his role as an evolutionary scientist. Designed to mix representatives from many disciplines with leaders in clinical and research oncology, the goal of the conference was to change the paradigm by which we approach the treatment of cancer. While discussion about existing lines of investigation did round out the meeting, most of the intense debate centered on ecological and evolutionary theory applied to cancer. I had three of the best days of my life with this group, and I cannot think of any experience which has so reminded me of the finest arguments in an Exeter classroom, except that, at last, I have grown self-certain enough to speak out.

I winkled myself in the door of the conference by offering to take notes. I spent perhaps two months preparing—reading Ruddon's Cancer Biology, which I would recommend to anyone interested, and reading largely in Cancer Medicine, which I recommend to those who wish to perform their own operation.

As Bruce and I studied for this meeting, we found cancer so extraordinarily effective within the human system that we began wondering "are the characters of cancer adaptive?" People are accustomed to thinking of cancer as a disease, the alien within, but this may blind us from understanding why and how it works. Recognizing that our purpose was to create new ways of seeing, we asked ourselves what positive role cancer might play in making us what we are.

From an evolutionary perspective, many characteristics of cancer resemble those that occur during stages of embryonic development in all complex, multi-celled animals. If cancer is viewed as an inadvertent "replaying" of developmental processes, it becomes no longer a disease and an invader but an error in timing. Further, many characteristics of tumors may stem from our body's ability to heal itself. Most cells are specialized and cannot produce other types of cells, but stem cells retain such capability, lest we die from random damage before we reproduce. Stem cells then have the ability to heal us, but on losing their built-in controls they can create cancer. Given these characteristics, no virtue exists that will protect us entirely from what we are. No matter what we eat, what we do, how we exercise or sleep or pray, we all possess this capacity to have cancer.

Ideas like these resonated in the context of the meeting. So too did new approaches to the problem, evolving as arguments heated. When it was all over, I wondered how this same sort of a conference might help other oncologists or quite different disciplines and thereby all of us. The experience was an immense affirmation of the importance and the truly liberating effect of a broad education—in fact and in agility—such as the one Exeter affords its students.

So I am moved to write to make a plea for diversity. Whenever you look at the prerequisites for candidates filling positions in your company or school, remember that even the study of dead plants (paleobotony) has something to say to cancer. We have specialization in our individual fields, even my own (which remains landscape painting), and it is necessary, but we cannot allow it to stifle the possibilities. All that is really required is an open, flexible mind, capable of discipline, with a ruthless turn for honesty.

No one reading this lives untouched by cancer. Yes, I thought frequently during the weekend of Fred Tremallo and of the all too many people dear to me whom I have lost or am losing to cancer. But I left the experience of that weekend humbled and exhilarated by the passion and creative intensity I witnessed, profoundly moved and profoundly hopeful.

—Robin Gowen Tiffney '75